senna

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senna

 [sen´ah]
the dried leaflets of Cassia acutiflora; used in a syrup, fluid extract, or compound powder as a cathartic.

senna, sennosides

Argoral (CA), Black Draught, Ex-Lax Gentle, Fleet Pedia-Lax Quick Dissolve, Fletcher's, Maximum Relief Ex-Lax, Nu-Lax (CA), Perdiem, Senexon, Senna-Gen, Sennatural, Senokot, Senokot Granules, SenokotXTRA, Senolax, Sure-Lax (UK)

Pharmacologic class: Anthraquinone laxative

Therapeutic class: Laxative (stimulant)

Pregnancy risk category C

Action

Causes local irritation in colon, which promotes peristalsis and bowel evacuation. Softens feces by increasing water and electrolytes in large intestine.

Availability

Granules: 15 mg/tsp

Liquid: 8.8 mg/5 ml, 25 mg/5 ml, 33.3 mg/ml (concentrate)

Tablets: 8.6 mg, 10 mg, 15 mg, 17 mg, 25 mg

Strips (orally disintegrating): 8.6 mg

Tablets (chewable): 10 mg, 15 mg

Indications and dosages

Acute constipation; preparation for bowel examination

Adults and children ages 12 and older: For acute constipation, 12 to 50 mg P.O. daily or b.i.d. For bowel preparation, 105 to 157.5 mg (concentrate) 12 to 14 hours before scheduled procedure.

Children ages 6 to 11: 50% of adult dosage. Or, two orally disintegrating strips; don't exceed four strips in 24 hours.

Children ages 2 to 5: 33% of adult dosage. Or, one orally disintegrating strip; don't exceed two strips in 24 hours.

Contraindications

• Hypersensitivity to drug or its components

• GI bleeding or obstruction

• Suspected appendicitis or undiagnosed abdominal pain

• Acute surgical abdomen

• Fecal impaction

• Inflammatory bowel disease (such as Crohn's disease)

Precautions

Use cautiously in:

• pregnant or breastfeeding patients

• children.

Administration

• Give with a full glass of cold water.

• To prepare patient for bowel examination, give 12 to 14 hours before procedure, followed by a clear liquid diet.

Adverse reactions

GI: nausea, vomiting, diarrhea, abdominal cramps, nutrient malabsorption, yellow or yellowish-green feces, loss of normal bowel function (with excessive use), dark pigmentation of rectal mucosa (with long-term use), protein-losing enteropathy

GU: reddish-pink discoloration of alkaline urine, yellowish-brown discoloration of acidic urine

Metabolic: electrolyte imbalances (such as hypokalemia)

Other: laxative dependence (with long-term or excessive use)

Interactions

Drug-diagnostic tests. Calcium, potassium: decreased levels

Patient monitoring

• Assess bowel movements to determine laxative efficacy.

• In long-term use, monitor fluid balance, nutritional status, and electrolyte levels and watch for laxative dependence.

Patient teaching

• Tell patient using drug for constipation to take at bedtime with a glass of water.

• Instruct patient to place orally disintegrating strips on the tongue, allow strip to dissolve, then drink plenty of water.

• In long-term use, advise patient to watch for and report signs and symptoms of nutritional deficiencies and fluid and electrolyte imbalance.

• If patient will undergo bowel examination, advise him to take drug 12 to 14 hours before procedure, followed by a clear liquid diet.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the tests mentioned above.

sen·na

(sen'ă),
The dried leaflets or legumes of Cassia acutifolia (Alexandrine senna) and C. angustifolia (Tinnevelly or Indian senna); a laxative.
[Ar. senā]

senna

(sĕn′ə)
n.
1. Any of various plants in the pea family, chiefly of the genera Senna and Chamaecrista, having pinnately compound leaves and showy, nearly regular, usually yellow flowers, used as ornamentals and for medicinal purposes.
2. A preparation of the dried leaves of Senna alexandrina, used as a laxative.

senna

Herbal medicine
A shrub native to northern and eastern Africa, which contains emodin and anthraquinone glycosides (sennosides A and B); it is primarily used as a laxative.
 
Toxicity
In excess, senna may evoke nausea, vomiting and colic; it should not be used in pregnancy or in those who are nursing, or who have colitis, haemorrhoids or ulcers. Overuse may be associated with so-called lazy bowel syndrome.

senna

A stimulant laxative drug used to treat constipation. The drug is on the WHO official list. A brand name is Senokot.